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The retention of emergency patients is a common problem faced by hospitals worldwide. In addition to medical problems, social, family, economic and other problems will also cause patients to stay in the emergency department. It not only brings challenges to patients’ own disease treatment and hospital operation and management, but also brings ethical dilemmas. Taking the service cases of medical social workers who involved in stranded patients in Shanghai E Hospital as an example, this paper analyzed 20 service records and interviews with social workers receiving cases, and combed the ethical dilemmas faced by medical social workers in the process of involving in emergency stranded patients. It was found that medical social workers faced many ethical dilemmas in the process of involving in emergency stranded patients, such as interpersonal relations and relevant legal regulations, the right to life and health and the right to informed consent, the self-determination of case owners and the allocation of medical resources. In this regard, it is suggested to solve the problem of patient retention by advocating the improvement of relevant systems and policies, building cooperative teams to smooth referral channels, strengthening education, and promoting family shared decision-making.
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Objective:To investigate the effect of functional movement assessment on the recurrence of patients with ankylosing spondylitis (AS) after treat-to-target therapy.Methods:The clinical data of 61 patients with AS in Chengdu were collected including clinical symptoms and AS disease activity (ASDAS). After 24 weeks adalimumab treatment, motor function score of AS patients(ASDAS<1.3) was assessed by functional movement screen (FMS), then adalimumab was discontinued and the rest of the concurrent drugs were continued until the disease relapse or up to 1 year. The data of the two groups were compared using t-test analysis and Cox proportionate hazard model. Results:① The recurrence rate of patients with AS after treat-to-target therapy within 1 year follow-up was 57.4%; ② The recurrence group was younger [(27±7) vs (31±6), t=5.96, P=0.02], the ASADAS value was at the high end when adalimumab was withdrawal [(1.29±0.07) vs (0.87±0.16), t=177.31, P<0.01], and the FMS value was lower after treat-to-target [(12.9±2.7) vs (16.2±1.9), t=29.23, P<0.01], The time to reaching the treatment target was longer [(2.9±1.2) month vs (1.7±0.6) month, t=19.89, P<0.01] than the stable group; ③ The cut-off value of the FMS test of AS patients after treat-to-target therapy was 14.25 (sensitivity was 84.6%, specificity was 80%) . The time to treat-to-target was a risk factor for recurrence ( RR=2.285, P<0.05), and the FMS value after treat-to-target was a protective factor ( RR=0.625, P<0.05). Conclusion:After discontinuing the adalimumab, about half of the patients relapse. The time reaching the treatment target and the FMS value after treat-to-target therapy are the risk factors for disease recurrence.
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Objective:To investigate the effect of baseline function movement assessment of ankylosing spondylitis (AS) on treatment outcomes.Methods:The clinical data of 90 patients with AS who met the medical insurance treatment for major disease in Chengdu were collected including clinical symptoms, functional movement screen (FMS) and ankylosing spondylitis disease activity score (ASDAS) after 24 weeks adalimumab treatment. They were divided into the non-treat-to-target group and the non-treat-to target group based on the ASDAS score, t-test or χ2 test was used to compare the differences between the two groups. Logistic regression model was used to analyze the influence of baseline FMS on the outcome of patients reaching the treatment target. Results:① The two groups were different in the FMS [(15.8±2.3) vs (12. 6±2.5), t=6.17, P<0.001], squat [(2.2±0.6) vs (1.7±0.5), t=3.57, P=0.001], hurdle spanning [(2.2±0.7) vs (1.8±0.6), t=2.11, P=0.038], straight lunge [(2.3±0.7) vs (1.7±0.5), t=4.23, P<0.001], shoulder flexibility [(2.5±0.6) vs (2.2±0.8), t=2.21, P=0.037], active straight leg raise [(2.1±0.6) vs (1.8±0.6), t=2.35, P=0.021], spinal stabilization pushups [(2.4±0.7) vs (1.8±0.8), t=3.76, P<0.001], body rotation stability [(2.2±0.7) vs (1.6±0.8), t=3.42, P=0.001] at baseline. ② The two groups were different in ASDAS score [(0.96±0.28) vs (2.19±0.52), t=14.69, P=0.000], FMS [(17.4±1.9) vs (12.7±2.8), t=9.77, P<0.001], deep squat [(2.6±0.5) vs (1.5±0.5), t=9.09, P<0.001], hurdle step [(2.2±0.6) vs (1.8±0.8), t=2.80, P=0.006], straight lunge [(2.6±0.6) vs (1.8±0.9), t=4.85, P<0.001], shoulder flexibility [(2.8±0.4) vs (2.5±0.5), t=2.10, P=0.038], active straight leg raise [(2.2±0.6) vs (1.9±0.8), t=2.46, P=0.016], spinal stability push-ups [(2.8±0.4) vs (1.6±0.7), t=10.36, P<0.001], and body rotation stability [(2.3±0.7) vs (1.6±0.8), t=4.76, P<0.001] at the end of the observation. ③ The cut-off value of the FMS for predicting whether AS patients meet the standard at baseline was 14.25 points (Sensitivity 0.733, specificity 0.800). ④ Logistic regression results showed that in the baseline, FMS series of action tests, squat [ OR (95% CI)=0.155 (0.035, 0.677), P=0.013], straight lunge [ OR (95% CI)=0.375 (0.148, 0.953), P=0.039], spinal stability push-ups [ OR(95% CI)=0.136(0.043, 0.436), P=0.001], and body rotation stability [ OR(95% CI)=0.308 (0.121, 0.780), P=0.013] were the influencing factors of the AS patient's treatment outcome ( P<0.05). Conclusion:The AS patients in the non-treat-to-target group have better FMS tests at baseline and at the end of the study than the non-treat-to-target group. Squats, straight lunges, remember stable push-ups, and body rotation stability are the influencing factors for the treatment outcomes of AS patients at baseline.
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ObjectiveBased on the antidepressant activity， the optimal ratio of Rehmanniae Radix and Lilii Bulbus in Baihe Dihuangtang was optimized and its possible mechanism was preliminarily explored. MethodA total of 100 male mice were randomly divided into normal group， model group， Rehmanniae Radix single decoction group， Lilii Bulbus single decoction group， and 5 different ratios of Baihe Dihuangtang group （Rehmanniae Radix-Lilii Bulbus 5∶6， 5∶5 ， 5∶4， 5∶3， 5∶2）， fluoxetine hydrochloride group. Except for the normal group， the remaining 9 groups were treated with chronic unpredictable mild stress method （CUMS） for 21 consecutive days to establish the depression mouse model.The Rehmanniae Radix single decoction group， Lilii Bulbus single decoction group and 5 different ratios of Baihe Dihuangtang group were administered with corresponding drugs at a dose of 2 g·kg-1 respectively， and fluoxetine hydrochloride group was administered fluoxetine hydrochloride at a dose of 0.01 g·kg-1， the normal group and the model group were respectively given an equal volume of normal saline by gavage for 21 consecutive days. The antidepressant effect of Baihe Dihuangtang with different ratios was evaluated by behavioral experiments. Western blot was used to detect the expression levels of brain-derived neurotrophic factor （BDNF） and tyrosine kinase receptor B （TrkB） in hippocampus. The level of total superoxide dismutase （SOD） in hippocampus was detected by hydroxylamine method. The level of reduced glutathione （GSH） in hippocampus was detected by spectrophotometric method. The levels of glutathione peroxidase （GPX） and glutathione S-transferase （GST） in hippocampus was detected by colorimetric method. The level of malondialdehyde （MDA） in hippocampus was detected by thiobarbituric acid method， and preliminary exploration of its antidepressant mechanism. ResultCUMS caused a significant decrease in the preference rate of sugar water and a significant prolongation of forced swimming and tail suspension immobility time （P<0.01）， while the different ratios of Baihe Dihuangtang and the single decoction of Rehmanniae Radix and Lilii Bulbus were significantly reversed to varying degrees. Abnormalities of the above indicators were observed （P<0.05， P<0.01）， especially when the ratio of 5∶6 had the most obvious effect on the above indicators， Moreover， CUMS caused the hippocampal BDNF and the expression of TrkB， SOD and glutathione antioxidant-related indexes were significantly decreased （P<0.01）， and the levels of lipid peroxidation product MDA was significantly increased （P<0.01）. However， the superior ratio of Baihe Dihuangtang （Rehmanniae Radix-Lilii Bulbus 5∶6， 5∶5， 5∶4） and the single decoction of Rehmanniae Radix and Lilii Bulbus significantly reversed the abnormality of the above indicators to varying degrees （P<0.05， P<0.01）. ConclusionIn summary， 5 different ratios of Baihe Dihuangtang and the single decoction of Rehmanniae Radix and Lilii Bulbus can produce antidepressant effect， especially when the ratio of 5∶6 had the most obvious effect on the above indicators， and the antidepressant effect gradually weakens with the proportion of Lilii Bulbus in the recipe decreases， and its mechanism may involve enhancing the nutritional level and antioxidant defense ability of hippocampal central nervous system.
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Classic hypothalamic-pituitary-end-organ feedback loops – the hypothalamic-pituitary-adrenal axis (HPAA), hypothalamic-pituitary-thyroidal axis (HPTA), and hypothalamic-pituitary-gonadal axis (HPGA) – are associated with the neuroendocrine and immune systems in major depressive disorder (MDD). Female patients with MDD present with evident neuroendocrine and immunological changes. Glucocorticoid, thyroid hormone, and reproductive steroid levels fluctuate with menstrual cycles, which might lead to glucocorticoid receptor resistance, impairment of triiodothyronine conversion, and sex hormone secretion disorders. In this review, we summarize the independent and interactive functions of these three axes in female MDD patients. The similar molecular structure of steroids implies an interrelationship between the hypothalamic-pituitary-end-organ axes and the competitive inhibitory effects at the receptor level, especially when considering the HPAA and HPGA.
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Objective:To examine the effects of transcutaneous electrical acupoint stimulation(TEAS)on pain and rapid recovery in elderly patients undergoing thoracoscopic surgery.Methods:A total of 60 elderly patients undergoing thoracoscopic surgery were randomly divided into the TEAS group and the control group.Patients in the TEAS group received TEAS in bilateral acupoints of Hegu, Neiguan, Houxi and Zhigou at a frequency of 2/100 Hz for 30 min before anesthesia induction.The electrical stimulation intensity went from weak to strong, and gradually adjusted to the patient's maximum tolerance(10 to 15 mA)continuously for 30 min; TEAS continued during intraoperative anesthesia with a stimulation intensity of 30 mA and a frequency of 2/100 Hz until the end of surgery.Patients in the control group were given electrode pads at the same acupoints without electrical stimulation.Results:Compared with the control group, patients in the TEAS group were associated with significantly decreased doses of Sufentanil[(57.93±5.54)μg vs (44.30±4.03 )μg, t=-10.903, P=0.000)], Remifentanil[(1.56±0.26)μg vs (1.08±0.18)μg, t=-8.3043, P=0.000)], Propofol[(763.23±62.04)mg vs (559.20±46.44) mg, t=-14.420, P=0.000)]and Dexmedetomidine[(545.07±53.36) vs (301.67±43.27) μg, t=-19.405, P=0.000)], reduced frequency of analgesic pump pressing(9.9±2.0 vs 2.9±1.3, t=-10.903, P=0.000), decreased VAS scores 24 h(3.53±1.07 vs 1.90±0.66, t=-7.090, P=0.000)and 48 h(1.37±0.61 vs 0.93±0.37, t=-4.660, P=0.000)postoperatively.Time to regaining consciousness, extubation and detachment were also markedly shortened in the TEAS group.In addition, time to postoperative feeding and time to postoperative ambulation were also reduced.Postoperative hospitalization days( P<0.05)and anesthesia cost( P<0.01)both significantly decreased in the TEAS group compared with those in the control group.Patients in the TEAS group had lower rates of nausea, vomiting, decreased oxygen saturation, dyspnea, dizziness, agitation and lethargy, and increased heart rate and decreased mean arterial pressure after the opening of the pleura(H1)compared with those in the control group(all P<0.05). Bispectral indexes were maintained between 40 and 60 after anesthesia in both groups(all P<0.01). Conclusions:TEAS-assisted anesthesia can effectively alleviate pain in elderly patients undergoing thoracoscopic surgery and promote rapid recovery after operation.
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Objective@#To evaluate and describe the changes of core muscle groups based on DAVID spine biomechanics training system in ankylosing spondylitis (AS) patients.@*Methods@#The clinical data of 100 patients of AS and 31 healthy controls were collected. Clinical symptoms, Bath ankylosing spondylitis disease activity index (BASDAI), Bath ankylosing spondylitis function index (BASFI), Bath ankylosing spondylitis measurement index (BASMI), ankylosing spondylitis disease activity (ASDAS), and simultaneous detection of DAVID spine biomechanics training system, simple core muscle fitness test: Eight-grade abdominal bridge, PLANK exercise (flat support), Abdominal static muscle endurance test, Back static muscle endurance test were compared using t-test analysis and spearman correlation analysis.@*Results@#① Between AS and healthy male control o group, there were significant differences of spinal mobility in forward flexion, right rotation, left rotation (42±13 vs 48±1, 52±14 vs 69±12, 52±13 vs 58±11; all P values <0.05); and significant differences of spinal muscle strength in forward bending force, right rotation force, left rotation force, right bending force (103±42 vs 146±17, 87±34 vs 104±13, 80±35 vs 101±13, 161±55 vs 186±19; all P values <0.05), and significant differences in the left/right rotational force (1.17±0.21 vs 1.02±0.111, P<0.05) of spine balance strength comparison.② Between AS and healthy controls of female group, there were differences in forward bending force (49±23 vs 77±10, P<0.05) of spinal muscle strength; and significant differences in forward bending/backward extension strength, left and right rotation strength (0.32±0.11 vs 0.58±0.21, 1.29±0.21 vs1.03±0.11, all P values <0.05) of spine balance strength; ③ In AS group, the spinal mobility was correlated with age (Rear extension r=-0.28, right flexion r=-0.268, left flexion r=-0.404, right rotation r=-0.367, left rotation r=-0.235; all P values <0.05), course of disease (Rear extension r=-0.354, forward flexion r=-0.283, right flexion r=-0.204, left flexion r=-0.284, right rotation r=-0.339, left rotation r=-0.23; all P values <0.05), body mass index (BMI) (Rear extension r=-0.23, forward flexion r=-0.288, right flexion r=-0.22, left flexion r=-0.201, right rotation r=-0.26, left rotation r=-0.29; all P values <0.05), sacroiliac joint stage(Rear extension r=-0.375, forward flexion r=-0.446, right flexion r=-0.331, left flexion r=-0.367, right rotation r=-0.368, left rotation r=-0.314; all P values <0.05) and BASDAI (Rear extension r=-0.381, forward flexion r=-0.374; all P values <0.05). Spinal muscle strength was correlated with gender (Posterior extensor force r=0.344, flexor force r=0.507, right rotation force r=0.376, left rotation force r=0.399, right flexion force r=0.433, left flexion force r=0.445; all P values <0.05); the left/right spine rotation strength was correlated with gender (r=0.271, P<0.05). ④ In the simple core muscle fitness test, eight-grade abdominal bridge was correlated with spinal muscle strength (Rear extension force r=0.234, right rotation r=0.290, left rotation r=0.219, right flexion r=0.35, left flexion r=0.327; all P values <0.05); PLANK exercise was correlated with spinal muscle strength (Rear extension force r=0.234, right rotation r=0.290, left rotation r=0.219, right flexion r=0.35, left flexion r=0.327; all P values <0.05); abdominal static muscle endurance test was correlated with forward flexion strength (r=0.341, P<0.05); back static muscle endurance test was correlated with spinal mobility (Rear extension r=0.262, forward flexion r=0.23, right rotation r=0.455, left rotation r=0.426, right flexion r=0.387, left flexion r=0.46; all P values <0.05); correlated with spine strength (right flexion r=0.256, left flexion r=0.272; all P values <0.05).@*Conclusion@#Compared with healthy people, AS patients have decreased activity, strength and balance of spinal core muscle. There are significant decline in spinal mobility and muscle strength of male AS patients and muscle imbalance of female AS patients. Simple core muscle fitness test could be used in clinic to measure the changes of AS patients'core muscle group.
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Objective To investigate the correlation of spinal mechanical imbalance and thoraco-dorsal pain of ankylosing spondylitis (AS). Methods The clinical data of 90 patients with AS were collected. Patients were divided into two groups according to the presence of thoracodorsal pain: the AS with thoraco-dorsal pain group (30 cases) and the AS without thoraco-dorsal pain group (60 cases). Clinical symptoms, Bath ankylosing spondylitis disease activity index (BASDAI), Bath ankylosing spondylitis function index (BASFI), Bath ankylosing spondylitis measurement index (BASMI), ankylosing spondylitis disease activity (ASDAS), and spinal mechanical function and nuclear myocardial force test were compared using t-test, one-way analysis of variance (ANOVA) analysis and Spearman correlation analysis. Results ① There were differences between thoraco-dorsal pain group and patients without thoracodorsal pain group at the time of back muscle strength [(0.82±0.41) min vs (1.33±0.74) min, F=12.372, P=0.001]; ②Thoraco-dorsal pain in the AS group was mainly the middle and lower thoracic vertebrae, such as the inflammation of rib head and rib transverse process, facial arthritis, and spinous ligaments, etc. And the missed diagnosis rate of magnetic resonance imagin (MRI) was high. ③ In healthy control group, the anterior flexion strength of thoracodorsal pain group was signific-antly different from that of patients without thoracodorsal pain [(92.1 ±46.3) Nm vs (126.6±35.7) Nm, F=6.440, P=0.002]. ④ There was significant difference in spinal strength as well as left and right rotation strength between the thoracodorsal pain group and patients without thoracodorsal pain [(1.18 ±0.22) vs (1.05 ±0.17), F=10.044, P<0.01];⑤In the thoraco-dorsal pain group, the right/left index was related to BASDAI (r=-0.522, P=0.004). For spinal mobility, the right/left index was related to cross cutting faces to right ( r=0.435, P=0.021), cross cutting faces to left (r=0.528, P=0.004). In spinal strength, the right/left index was related to left turn (r=0.57, P=0.001); right lateral flexion (r=0.368, P=0.049) and left lateral flexion (r=0.369, P=0.049). Conclusion The thoracodorsal pain of AS is dominated by the middle and lower thoracic vertebrae, and the missed diagnosis rate of MRI is high. The imbalance of the left and right side of the spine is one of the factors of the thoracic back pain in AS.
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Objective To evaluate and describe the changes of core muscle groups based on DAVID spine biomechanics training system in ankylosing spondylitis (AS) patients.Methods The clinical data of 100 patients of AS and 31 healthy controls were collected.Clinical symptoms,Bath ankylosing spondylitis disease activity index (BASDAI),Bath ankylosing spondylitis function index (BASFI),Bath ankylosing spondylitis measurement index (BASMI),ankylosing spondylitis disease activity (ASDAS),and simultaneous detection of DAVID spine biomechanics training system,simple core muscle fitness test:Eight-grade abdominal bridge,PLANK exercise (fiat support),Abdominal static muscle endurance test,Back static muscle endurance test were compared using t-test analysis and spearman correlation analysis.Results ① Between AS and healthy male control o group,there were significant differences of spinal mobility in forward flexion,right rotation,left rotation (42±13 vs 48±1,52±14 vs 69±12,52±13 vs 58±11;all P values ＜0.05);and significant differences of spinal muscle strength in forward bending force,right rotation force,left rotation force,fight bending force (103±42 vs 146±17,87±34 vs 104±13,80±35 vs 101±13,161±55 vs 186±19;all P values ＜0.05),and significant differences in the left/right rotational force (1.17±0.21 vs 1.02±0.111,P＜0.05) of spine balance strength comparison.② Between AS and healthy controls of female group,there were differences in forward bending force (49±23 vs 77±10,P＜0.05) of spinal muscle strength;and significant differences in forward bending/backward extension strength,left and right rotation strength (0.32±0.11 vs 0.58±0.21,1.29±0.21 vs 1.03±0.11,all P values ＜0.05) of spine balance strength;③ In AS group,the spinal mobility was correlated with age (Rear extension r=-0.28,right flexion r=-0.268,left flexion r=-0.404,right rotation r=-0.367,left rotation r=-0.235;all P values ＜0.05),course of disease (Rear extension r=-0.354,forward flexion r=-0.283,right flexion r=-0.204,left flexion r=-0.284,right rotation r=-0.339,left rotation r=-0.23;all P values ＜0.05),body mass index (BMI) (Rear extension r=-0.23,forward flexion r=-0.288,right flexion r=-0.22,left flexion r=-0.201,right rotation r=-0.26,left rotation r=-0.29;all P values ＜0.05),sacroiliac joint stage(Rear extension r=-0.375,forward flexion r=-0.446,right flexion r=-0.331,left flexion r=-0.367,right rotation r=-0.368,left rotation r=-0.314;all P values ＜0.05) and BASDAI(Rear extension r=-0.381,forward flexion r=-0.374;all P values ＜0.05).Spinal muscle strength was correlated with gender (Posterior extensor force r=0.344,flexor force r=0.507,right rotation force r=0.376,left rotation force r=0.399,right flexion force r=0.433,left flexion force r=0.445;all P values ＜0.05);the left/right spine rotation strength was correlated with gender (r=0.271,P＜0.05).④ In the simple core muscle fitness test,eight-grade abdominal bridge was correlated with spinal muscle strength (Rear extension force r=0.234,right rotation r=0.290,left rotation r=0.219,right flexion r=0.35,left flexion r=0.327;all P values ＜0.05);PLANK exercise was correlated with spinal muscle strength (Rear extension force r=0.234,right rotation r=0.290,left rotation r=0.219,right flexion r=0.35,left flexion r=0.327;all P values ＜0.05);abdominal static muscle endurance test was correlated with forward flexion strength (r=0.341,P＜0.05);back static muscle endurance test was correlated with spinal mobility (Rear extension r=0.262,forward flexion r=0.23,right rotation r=0.455,left rotation r=0.426,right flexion r=0.387,left flexion r=0.46;all P values ＜0.05);correlated with spine strength (right flexion r=0.256,left flexion r=0.272;all P values ＜0.05).Conclusion Compared with healthy people,AS patients have decreased activity,strength and balance of spinal core muscle.There are significant decline in spinal mobility and muscle strength of male AS patients and muscle imbalance of female AS patients.Simple core muscle fitness test could be used in clinic to measure the changes of AS patients'core muscle group.
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Neuroimmune system may be involved in the pathological process of bipolar disorder (BD), but the essential association is not fully understood. Accumulating evidence has shown that BD involves the activation of immune cells and the release of inflammatory substances in the central nerve system (CNS). Meanwhile, neuroimmune responses also interact with other hypothesis of the etiology of BD that are widely recognized, such as neurotransmitter systems, neuroendocrine systems, neurotrophic factors, and oxidative stress. Simultaneously, related genes and immune changes in peripheral blood vary with it. Overall, neuroimmunity may play an important role in the pathogenesis of BD, and the inflammatory cytokines, especially interleukin-6 and tumor necrosis factor-alpha, have potential value for the clinical diagnosis and prognosis of BD, as well as predicting the therapeutic effects of drugs. Large-scale studies are needed to extend the evidence on neuroimmunity in BD, and to examine its clinical value for applications such as early prediction and treatment.
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Objective To observe the effect of pretreatment with Rhizoma Alismatis extract on cardiac function and cysteinyl aspartate specific protease-3 (caspase-3)in ischemia-reperfusion injury of rats.Methods Male Sprague-Dawley(SD)rats were randomized into a sham-operated group (S group),an ischemia-reperfusion group(IR group),Rhizoma Alismatis water extract group(S1 group),Rhizoma Alismatis alcohol extract group(S2 group)and Rhizoma Alismatis polysaccharide group(S3 group).At the end of 14-day of intragastric gavages,rats were subjected to 40 min(T1)of LAD(left anterior descending)coronary artery ligation (ischemia)and 120 min (T2)of ligation loosening (reperfusion),called as myocardial ischemia-reperfusion(IR)models.Then,at the end of T1 and T2,the left ventricular end diastolic pressure (LVEDP),left ventricular systolic pressure (LVSP),and maximum rise/fall rate of left intraventricular pressure(± dp/dtmax)were recorded respectively.The level of creatine kinase(CK)and lactate dehydrogenase(LDH)were determined.The area of myocardial infarction and the expression level of caspase-3 protein were tested.Results At end of T2,compared with the index values of IR group as a non-treatment control[LVEDP(6.70 ±0.22)mmHg,LVSP (86.16±15.11)mmHg,+dp/dtmax(997.99±151.03)mmHg,-dp/dtmax(663.71±68.55)mmHg,CK(10.54±2.04)U/L,LDH(296.51±7.00)U/L,the size of myocardial infarction(39.82±11.80)％and expression level of caspase-3(123.42±14.77)],the treatment groups of S1,S2,and S3 showed a lower levels of LVEDP [(5.89 ± 0.47) mmHg,(5.89 ± 0.67) mmHg,(6.07 ±0.51) mmHg],of activity of CK[(8.60± 1.67)U/L(8.90±1.27)U/L,(9.39±0.83) U/L],of LDH[(239.33±30.81) U/L,(223.63 ± 20.26) U/L,(241.19 ± 45.56) U/L],of size of myocardial infarction[(30.39 ± 5.44) ％,(32.18±5.90)％,(33.12±8.16)％],and of expression level of caspase3 protein[(73.44± 15.28),(65.47±12.53),(65.05± 10.45)],(all P＜0.01 or＜0.05);but showed a higher levels of LVSP[(99.24±12.00)mmHg,(97.05±12.45)mmHg,(97.06±7.61) mmHg],and of ±dp/dtmax [(1 137.33±85.70)mmHg,(1 147.24±118.07)mmHg,(1 124.50±141.47)mmHg];[(604.77± 68.37)mmHg,(616.61±46.73)mmHg,(708.76±81.44)mmHg],(all P＜0.01 or＜0.05).Conclusions Pretreatment with Rhizoma Alismatis extract can effectively improve the cardiac function of ischemic repeffusion injury in vivo in rats,and reduce myocardial infarction size and myocardial enzyme release.The mechanism may be related to the down-regulation of apoptotic protein caspase-3 in myocardial tissue.
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Objective: To explore pulse characteristic of the health female college students and their relationship with menstrual cycle. Methods: The subjects were 17 female college students of Jiangxi University of Traditional Chinese Medicine. Pulse test was performed with pulse bracelet. The detection time was every day in the wake and has not yet get up and wake up at any time before going to bed with a pulse-taking bracelet, and recorded the current menstrual cycle information. The pulses of the wake that has not yet get up and wake up at any time before going to bed took consistency analysis of the record with Kruskal Wallis Test. The pulse of menstruation stage analysis was compared with chi-square test. Results: The pulses of the wake that has not yet get up and wake up at any time before going to bed consistency was poor except rapid pulse (P＞ 0.05) . The occurrence frequency of slippery pulse and string-like pulse were 55.21％ and26. 03％ respectively. The pulses of premenstrual period, post menstrual period and menstrual period were not much different from others. The occurrence frequency of moderate pulse, string-like pulse, unsmooth pulse, slippery pulse in intermenstrual period respectively were 40.68％, 44.07％, 30.51％, and 40.68％. The occurrence frequency of moderate pulse, string-like pulse, unsmooth pulse, slippery pulse in-non intermenstrual period respectively were 17.38％, 24.69％, 10.45％, 56.30％. The difference was significant (P ＜ 0.05) . Conclusion: The female college students are mainly in terms of slippery pulse. The occurrence frequency slippery pulse in intermenstrual period respectively are less common. The string-like pulse, moderate pulse, unsmooth pulse in intermenstrual period are more common than in-non intermenstrual period.
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Objective To explore the application effect of paclitaxel combined with carboplatin neoadjuvant chemotherapy in patients with advanced cervical carcinoma.Methods Forty patients with stage Ⅱa and above cervical cancer who were treated between August 2015 and August 2016 were selected as the research objectives and all patients were diagnosed by pathological examination.They were divided randomly into experimental group(n=20)and control group(n=20).Patients in the experimental group were treated with intravenous chemotherapy before operation.This scheme included paclitaxel and carboplatin.It included 2 cycles,and the interval between the 2 cycles was 3 weeks.Extensive hysterectomy and pelvic lymphadenectomy were made in 14 days after chemotherapy.The patients in the control group were treated only with extensive hysterectomy and pelvic lymphadenectomy.The efficacy of neoadjuvant chemotherapy was evaluated according to WHO criteria,and observed the operation condition.Adverse drug reactions were evaluated according to WHO anti-cancer drug adverse reaction grade.The quality of life of the two groups was evaluated by the mos item short from health survey(SF-36).Results 20 patients completed chemotherapy,CR5 cases,PR11 cases,SD3 cases,PD1 cases,and the total effective rate(CR+PR)was 80％.At the same time,The paracervical tissue becomed soft in varying degrees,the gap widened,the invasive lesions were controlled in different degrees.Adverse reactions were mild and relieved without special treatment.There was no kidney and heart function damage.All cases were operated successfully after chemotherapy.There were no significant difference in operation time and blood loss between the two groups.The rate of lymph node metastasis,the infiltration rate of uterine tissue and the residual rate of tumor tissue in the vaginal margin were lower than those in the control group(P<0.01).The SF-36 scores of the two groups were higher than those before treatment,but the score of the experimental group was higher significantly than that of the control group,and the difference was statistically significant(P<0.01).Conclusion Paclitaxel combined with carboplatin in neoadjuvant chemotherapy of cervical cancer can reduce the tumor volume,increase the chance of surgery,has less toxic side effects,lower metastatic rate and improve the quality of life of patients.It is worthy of further clinical research and recommendation.
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Objective: To investigate the detection ability of two reagents by automated coagulation analyzer ACL-TOP using immune turbidimetric method, and to determine the merits and demerits of them. Methods:Two reagents were compared in the study. We selected 532 cases of hospitalized patients in Anzhen Hospital, 388 cases of which were unstable angina, 60 cases were pulmonary thromboembolism, 70 cases were coronary atherosclerosis, 14 cases were abdominal aneurysm, and the rest were the patients with high blood pressure and coronary heart disease. The plasmas of all the patients were extracted, and D-dimer was detected on ACL-TOP by D-Dimer (referred to as reagent A) and D-DHS (referred to as reagent B). Results:The results of D-dimer increased in different degrees, and there are 88 cases of false positive cases. The case whose FDP and individual D-dimer of D-dimer simultaneous detection was elevating and clinical symptoms were disappeared was detected by the VIDAS instrument platform verification. There were significant differences between A and B. The detection result of reagent A was [1594.15±2286.18], and reagent B was [912.97±1814.06]. There were significant differences between them (t=3.654, P<0.05). In addition, the consistency of the two reagents was poor (r=0.419, P<0.05). Conclusion:Comparing two reagents to detect D-dimer quantitatively by automated coagulation analyzer ACL-TOP, D-DHS owns greater ability to exclude false-positive results, so does the ability of anti-interference with jaundice, hemolysis and chylemia.
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Objective To investigate the direct economic losses caused by healthcare-associated infection(HAI)in patients with acute lymphoblastic leukemia (ALL)and acute non-lymphoblastic leukemia (ANLL).Methods All acute leukemia (AL)adult patients who were admitted to a hematology ward in a hospital between January 201 1 and December 2013 were included in the study,HAI group(case group)and non-HAI group (control group),ALL group and ANLL group were matched respectively in a 1:1 ratio,hospitalization expenses and length of hospital stay were compared.Results A total of 994 patients were included,166 were with ALL,828 with ANLL,there were 181 pairs of case group and control group,and 15 pairs of ALL group and ANLL group. Direct economic los-ses in ALL group and ANLL group were 13 089.0 ￥ and 21 565.0 ￥ respectively ;extension of length of hospital stay due to HAI were 10.5 and 10.0 days respectively,differences were statistically significant between case group and control group (both P<0.05). The total hospitalization expense,as well as fees for bed,consultation,treat-ment,laboratory examination,nursing,medicine,traditional Chinese medicine,and blood transfusion in ANLL group were all higher than ALL group,but there were no significant difference.Conclusion HAI in patients with AL can increase hospitalization cost and prolong length of hospital stay.
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Objective To investigate the direct economic loss caused by oral infection in patients with acute leuke-mia.Methods Acute leukemia patients with oral infection in a tertiary first-class hospital in Shandong Province be-tween January 2011 and December 2013 were investigated,the 1 :1 matched case-control method was used for com-paring hospitalization expense and length of hospital stay between oral infected (case group)and uninfected patients (control group ).Results A total of 994 patients with acute leukemia were monitored,277 had healthcare-associated infection,17 (5.56%)of whom were with oral infection.The median hospitalization expense of patients in case group and control group was￥37 327 and￥13 176 respectively,the total hospitalization expense of patients in case group was 2.83 times more than control group,difference was statistically significant (Z = -3.621 ,P <0.001).Each hospitalization expense of case group was higher than control group,especially expense for medicine, blood transfusion,laboratory examination,and therapy.The median length of hospital stay in case group and con-trol group were 17 days and 11 days respectively,rank sum test showed that difference in median length of hospital stay between two groups was statistically significant (Z =-3.627,P < 0.001 ).Conclusion Acute leukemia pa-tients with oral infection have increased hospitalization expense,prolonged length of hospital stay,and increased the financial burden.
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Objective Using the third high sensitive cardiac troponin I assay to establish the reference intervals of serum cardiac marker high sensitivity cardiac troponin I ( hs-cTnI ) in apparently healthy subjects of Beijing area, and to explore the relationship between cTnI and other parameters.Methods Using random selection method, a total of 440 serum samples were collected from apparently healthy subjects of Beijing area.Among them, 217 cases were male, average age was (50.0 ±14.3) years old;223 cases were female, average age was ( 49.0 ±14.0 ) years old.All of these serum samples were detected hs-cTnI using i2000 Abott biochemical analyzer and ARCHITECT STAT Abbott assay kit.And the 99th percentile upper reference limit was used as the reference interval.Non-parametric tests were used to compare the different groups, the U Mann-Whitney test was used between two groups, the Kruskal-Wallis test was used in many groups, and the correlation analysis was used Spearman method.Results The 99th percentiles of hs-cTnI in 440 apparently healthy subjects is 9.66 ng/L.While the male group is 9.66 ng/L, and the female group is 8.25 ng/L.The serum hs-cTnI level of male is higher than female ( 9.95 ng/L vs 8.25 ng/L, P0),and appears negative correlation with platelet (PLT)(P<0.05,R<0).Conclusion The serum hs-cTnI level apparently differents with gender, so it is necessary to establish reference intervals among different gender group of Beijing area.
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Objective: To investigate the effects of sodium cantharidinate and vitamin B6 (SCAVB6) on cell proliferation, apoptosis and invasion of hepatic cancer cell line SMMC-7721 as well as the expression of heparanase (HPA). Methods: After treatment with 0.5, 1.0, 1.5 and 2.0 μg/mL SCAVB6 for 24, 48 and 72 h, the cell proliferation was detected by MTT assay. The cell apoptosis, invasion ability and the expression levels of HPA mRNA and protein of SMMC-7721 cells after treatment with 0.5, 1.0, 1.5 and 2.0 μg/mL SCAVB6 for 48 h were examined by flow cytometry (FCM), Transwell cell invasion assay, RT-PCR and Western blotting, respectively. Results: SCAVB6 could inhibit the proliferation of SMMC-7721 cells in a dose- and time-dependent manner (P < 0.05). The apoptotic rate of SMMC-7721 cells after treatment with SCAVB6 for 48 h was higher than that of the SMMC-7721 cells without any treatment, but the invasion ability was weakened (both P < 0.05). The expression levels of HPA mRNA and protein in SMMC-7721 cells after treatment with 1.0, 1.5 and 2.0 μg/mL SCAVB6 were lower than those in the SMMC-7721 cells without any treatment, and this inhibition effect was in a dose-dependent manner (all P < 0.05). Conclusion: SCAVB6 can inhibit the proliferation and invasion of SMMC-7721 cells. This effect may be related to the inhibition of expression of HPA.
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Sepis s is the leading cause of death in critically ill children,but it lack biomarkers with a higher sesn itivity and specificity for sepsis diagnosis,severity assessment,and prognostication.Soluble uroki-nase plasminogen activator receptor( suPAR) ,as a nvo el receptor ts imual ted by inflammation,is involved in the plasminogen activating pathways,inflammation and migration,adhesino ,chemotaxis,signal transduction of v ra ious immuen cell.suPAR serum levels have been shown to significantly incer ase in various infectious dis-easse .This revei w provided a ed scriptive overview of the role of suPARd etection in sepsis judgmne t and prognostication,hoping to find a perfetc biomarker for timely evaluait ng of chidlr en with spe sis and screening for childrena dmitted to the intensive care uin t in order to improve outcome and reduce mortality.